An audible click or snapping sensation with hip movement. When muscle tendons become inflamed, often from overuse, they can click as they rub over the hip socket bone. May or not be painful. SHS is more common in women, though it can affect people of all genders and ages.
Can occur due to three types of the condition:
- Internal type
- External type
- Intra-articular type
1-Internal type
- Iliospoas tendon snap
- Snapping of the iliopsoas tendon over the iliopectineal eminence.
- Iliopsoas tendon will snap over the pelvic brim iliopsoas bursitis.
- Inflammation of the bursa that lies between the front of the hip joint and the iliopsoas muscle.
- Ultrasound or MRI may be normal.
- May reveal bursal fluid anterior to the hip joint.
- Iliopsoas injection can be diagnostic
- Abduction and external rotation of the hip will also help in the diagnosis.
2-External type
- Iliotibial band syndrome
- The thickend iliotibial band snaps over the bony greater trochanter of the femur.
- The patient may develop trochanteric bursitis, adhesions, gluteus maximus inflammation or edema.
- Diagnosis of iliotibial band syndrome
- Direct palpation of the greater trochanter.
- Put the patient on the side
- The hip is placed in extension and rotate the hip till a pop is felt.
- Obers test
- Best clinical test
- It is a clinical examination test used to assess tightness of the iliotibial band.
- The patient should lay on the side with the unaffected leg on the bottom.
- The examiner will then slowly abduct the leg with the knee in flexion and the hip in extension.
- When the IT band is tight, the test is positive and the patient will be unable to adduct the legs and the knees will not come together.
3-Intra-articular type
- Hip joint labral tear or loose body.
- Painful labral tears are other causes of snapping hip syndrome.
- Decreased range of motion
- A painful click in the joint.
- Normal labrum is a black triangle structure shown as a normal healthy acetabular labrum. Dye is in the lateral recess.
- In acetabular or labral tear, MRI arthrogram shows contrast between the medial aspect of the labrum and acetabulum. Dye is medial.
What are the symptoms?
As its name indicates, SHS can result in an audible snapping or clicking sound. It often causes no pain, but you may feel a clicking or popping sensation when flexing your hip.
Other symptoms you may experience with this condition include:
- pain
- inflammation
- leg muscle weakness when trying to lift your leg sideways or forward
- swelling
- difficulty with regular physical activity such as walking or rising from your chair
- feeling your hip is coming out of place
How is snapping hip syndrome diagnosed?
Before recommending treatment, your doctor needs to determine the exact cause of your snapping hip. They will closely examine your medical history, evaluate your symptoms, and perform a physical examination.
Your doctor may also order X-rays to allow for full visibility of your bones and joints or an MRI scan to help rule out other hip disorders, including:
- Hip arthritis
- Hip joint synovitis, or inflammation in the hip joint membrane lining
- Tumors
Snapping Hip Syndrome Treatment
Unless snapping hip syndrome is painful or causes difficulty in sports or other activities, many people do not see a doctor or have it treated.
For minor snapping syndrome pain, try home treatments such as:
- Reducing or modifying activity
- Applying ice
- Using over-the-counter pain relievers
- For more severe pain or pain that does not improve with home treatment, see your doctor.
Physical therapy with emphasis on stretching, strengthening, and alignment can often help. Sometimes, treatment with a corticosteroid injection to the area can relieve inflammation. In rare cases, doctors may recommend surgery.
Snapping Hip Syndrome Stretches
Recommended exercises to treat snapping hip syndrome will vary depending on the type of snapping hip syndrome you have. Snapping hip syndrome stretches may include:
Quadriceps stretch. Standing arm’s length from a wall, place the hand opposite the painful hip against the wall for support. With your other hand, take hold of the ankle of the painful leg and, keeping your knees together, pull your ankle up toward your buttocks. Hold for 30 to 60 seconds and release. Repeat three times.
Hamstring stretch. Lie flat on your back on the floor in a doorway so that your upper body is on one side of the doorway and your lower body is on the other and the painful hip is against the door frame. Raise the painful leg and rest it against the wall next to the door frame. Hold for 30 to 60 seconds and then lower. Repeat three times.
Piriformis stretch. Lying on your back with both knees bent, place the foot of your uninjured leg flat on the floor and rest the ankle of your painful leg over the knee of your uninjured leg. Take hold of the thigh of the uninjured leg and pull the knee toward your chest. Hold for 30 to 60 seconds and release. Repeat three times.
Iliotibial band stretch. Standing with your legs together, cross your uninjured leg in front of the painful leg, then bend down and touch your toes. Hold for 30 seconds, then return to starting position. Repeat three times.
